Table 7.
Unique influence of context factors on increase/decrease in access arrangements and subsequent service level
| Access dimension and example/s | Context factors and unique influence on access arrangements (increase ↑, decrease↓ service level) | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Objectives of PHC model | Case size (small, medium, large) | Local workforce supply market conditions | Service stability (recent changes to structure, governance) | Location (ASGC) | Local population/patient profile identified need | IRSAD (local popn, or patient profile) | Relationship with LHN | Financial viability | |
| Availability & accommodation | |||||||||
| Onsite AH i.e. after 6 pm weekdays; on weekends | Where explicit↑ | Small↓ | Shortage/oversupply of GPs↑,↓ | Stable structure, governance and leadership may↑ | Inner/Outer regional↑ | Identified need↑ | No clear association | No clear association | Focus on financial viability↑,↓ |
| Same day/walk-in GP appointments | Where explicit↑ | No clear association | No clear association | No clear association | No clear association | No clear association | No clear association | No clear association | No clear association |
| Affordability | |||||||||
| Patient co-payments for non GP co-located services | Where explicit for vulnerable (including children) populations↑ | No clear association | No clear association | No clear association | No clear association | Identified need↑ | Ad hoc arrangement↑,↓ | Strong presence of LHN services associated with ↑ in affordability | Focus on financial viability↑,↓ |
| Acceptability | |||||||||
| Unique responses to acceptability to fit with context | Where explicit for vulnerable populations↑ | No clear association | No clear association | Governance and leadership stability ↑ | No clear association | Identified need↑ | No clear association | No clear association | Focus on financial viability (sub-population opportunity) may↑ |
| Appropriateness | |||||||||
| Co-location of allied health professionals (allied health)/medical specialists (med spec – priv/public)/Local hospital network (LHN) clinics | No clear association | No clear association | No clear association | No clear association | No clear association | No clear association | No clear association | Strong LHN relationship, referral network and communication↑ | Focus on financial viability (via rental opportunity) may↑ |
| Approachability | |||||||||
| Outreach programs (all provide some services in residential aged care settings and home visits) | Where explicit for vulnerable populations↑ | No clear association | No clear association | No clear association | No clear association | Identified need↑ | No clear association | No clear association | Focus on financial viability (sub-population opportunity) may↑ |